Comprehensive Physiology Wiley Online Library

Circulation to Skin and Adipose Tissue

Full Article on Wiley Online Library



Abstract

The sections in this article are:

1 Skin
1.1 Introduction
1.2 Arrangement of Vessels
1.3 Arteriovenous Anastomoses
1.4 Skin Vessels as Heat Exchangers
1.5 Measurement of Flow
1.6 Vasomotor Innervation
1.7 Reflex Control of Flow
1.8 Responses to Physical Stimuli
1.9 Responses to Humoral Agents
2 Adipose Tissue
2.1 Introduction
2.2 Arrangement of Vessels
2.3 Vascular Exchange
2.4 Measurement of Flow
2.5 Vasomotor Innervation
2.6 Reflex Control of Flow
2.7 Responses to Physical Stimuli
2.8 Responses to Humoral Agents
Figure 1. Figure 1.

Diagram of vascular anatomy in plantar skin.

From Conrad . Reproduced with permission from Conrad, M. C.: Functional Anatomy of the Circulation to the Lower Extremities. Copyright © 1971 by Year Book Medical Publishers, Inc., Chicago
Figure 2. Figure 2.

Effects of body cooling and heating on blood flow in normal and cutaneous nerve‐blocked forearm. CNB, cutaneous nerves on left side blocked with local anesthetic.

From Blair, Glover, and Roddie
Figure 3. Figure 3.

Forearm and hand blood flow before and during body heating. Rectangle represents period of body heating. •, Forearm flow; ○, hand flow in ml · 100 m−1 · min−1; ○, current (μA) flowing through forearm skin is an index of sweat gland activity.

From Roddie et al.
Figure 4. Figure 4.

Blood flow through bodies of hands before and during indirect heating. Circulation to digits was arrested by rubber bands applied around the base of each digit. ○, Control hand; •, experimental hand. Atropine sulfate (0.3 mg) was infused into the brachial artery on the experimental side immediately before observations commenced.

From Roddie et al.
Figure 5. Figure 5.

Schematic representation of changes in blood flow in normal and nerve‐blocked hand and forearm during body cooling and heating. At CNB, vasomotor nerves to the hand and forearm skin were blocked with local anesthetic solution.

Figure 6. Figure 6.

Effects of body cooling and heating on blood flow in normal and cutaneous‐nerve‐blocked forearm, upper arm, calf, and thigh: ▪, right side; □, left side. CNB, cutaneous nerves on left side blocked with local anesthetic.

From Blair, Glover, and Roddie
Figure 7. Figure 7.

Effect of cutaneous nerve block, body cooling, and body heating on skin temperature of ear. CNB, great auricular nerve to left ear blocked; ○, left ear; •, right ear.

From Blair, Glover, and Roddie
Figure 8. Figure 8.

Effect of heat flow from regions of upper chest by blocking cutaneous nerve supply. Failure to dilate during body heating and absence of vasoconstrictor reflexes in nerve‐blocked areas are clearly shown.

From Fox et al.
Figure 9. Figure 9.

Top: record from above downward shows signal, central venous pressure, and brachial arterial pressure. Depression of signal indicates period during which both common carotid arteries were compressed. Bottom: plethysmography tracings of calf and hand blood flow before, during, and after compression of both common carotid arteries; arrows mark beginning and end of compression. Static calibrations on plethysmographic record represent 10‐ml volume increases.

From Roddie and Shepherd
Figure 10. Figure 10.

Effect of Valsalva's maneuver on sympathetic activity recorded in a median nerve fascicle innervating glabrous skin. Upper tracing: respiratory movements, inspiration upward. Middle tracing: integrated sympathetic nerve activity. Lower tracing: arterial blood pressure.

From Delius et al.
Figure 11. Figure 11.

Effects of 2 consecutive periods of neck suction on total, muscle, and skin vascular resistance and blood flow and on mean arterial pressure and heart rate in a single subject. Each point represents mean value for all determinations made during each control and intervention period.

From Beiser et al.
Figure 12. Figure 12.

Effect of leg exercise on blood flow in the hand (▿) and forearm (•). Left panel: average result of 19 runs on 3 subjects when increase in oxygen consumption above resting level was <500 ml/min (avg 326 ml/min). Right panel: average result of 17 runs on the same subject when increase in oxygen consumption was >500 ml/min (avg 780 ml/min). Rectangle indicates 5‐min period of leg exercise.

From Blair, Glover, and Roddie , by permission of the American Heart Association Inc
Figure 13. Figure 13.

Effect of severe emotional stress on arterial pressure: Δ, heart rate; •, forearm blood flow; ○, hand blood flow. During the time indicated by rectangle, the subject was led to believe that he was suffering from severe blood loss.

From Blair, Roddie, et al.
Figure 14. Figure 14.

Effect of 2 min of ischemia on blood flow and oxygen saturation in deep superficial veins in forearm. Hatched lines: time of ischemia.

From Dornhorst
Figure 15. Figure 15.

Critical closure of digital blood vessels during reduction of transmural pressure in 4 subjects. Heat flow is expressed as percentage of flow from corresponding finger of opposite hand kept under control conditions at heart level. ○, Transmural pressure reduced by hand elevation; •, transmural pressure reduced by positive tissue pressure.

From Roddie and Shepherd
Figure 16. Figure 16.

Effect of increased transmural pressure on oxygen saturation of blood samples obtained from deep forearm vein. Forearm was exposed to a pressure 50 mmHg below atmospheric for period shown.

From Roddie and Shepherd
Figure 17. Figure 17.

Approximate levels of blood flow in the hand when immersed in water at temperatures between 0°–45°C and when vasoconstrictor fiber activity is inhibited (heat load), moderate (comfortable), and intense (cold stress).

From Folkow and Neil
Figure 18. Figure 18.

Heat loss (in cal · 100 ml−1 · min−1) from right index finger of single subject to water at 0°–6°C. Clear area represents heat derived from circulating blood. Pain is indicated by a roughly quantitative scale at top of the figure and relationship between pain and heat loss is striking.

From Greenfield et al.
Figure 19. Figure 19.

Effect of histamine (10 μg/min for 3 min) on forearm blood flow. Each point is mean of 3 blood flow rates recorded in each minute during 1–2 infusions in each of 5 subjects. Vertical bars, SEM. A: •, control response (2 infusions in each subject); ○, in presence of mepyramine (avg response to 2 infusions, the 1st after 25 mg, the 2nd after an additional 3–5 mg of mepyramine); ▪, in presence of both drugs together (30–35 mg mepyramine and 10–15 mg metiamide). B: •, control response (2 infusions in each subject); ▵, in presence of metiamide (avg of response to 2 infusions, the 1st after 10 mg, the 2nd after an additional 15 mg of metiamide; ▪, in presence of both drugs together (30–40 mg metiamide and 25 mg mepyramine).

From Chipman and Glover
Figure 20. Figure 20.

Effect of infiltrating local anesthetic solution around radial, ulnar, and median nerves to forearm on blood flow changes with CO2 inhalation. Black rectangle indicates period when the subject breathed 12.5% CO2 in O2. ○, Nerve‐blocked forearm; •, normal forearm.

From Blair, Roddie, et al.
Figure 21. Figure 21.

Effect of voluntary hyperventilation with air and 5% CO2 in 95% oxygen on blood flow through hand and forearm. •, Intact hand or forearm; ○, nerve‐blocked hand or forearm. Periods between dotted lines represent periods of hyperventilation.

From Roddie et al.


Figure 1.

Diagram of vascular anatomy in plantar skin.

From Conrad . Reproduced with permission from Conrad, M. C.: Functional Anatomy of the Circulation to the Lower Extremities. Copyright © 1971 by Year Book Medical Publishers, Inc., Chicago


Figure 2.

Effects of body cooling and heating on blood flow in normal and cutaneous nerve‐blocked forearm. CNB, cutaneous nerves on left side blocked with local anesthetic.

From Blair, Glover, and Roddie


Figure 3.

Forearm and hand blood flow before and during body heating. Rectangle represents period of body heating. •, Forearm flow; ○, hand flow in ml · 100 m−1 · min−1; ○, current (μA) flowing through forearm skin is an index of sweat gland activity.

From Roddie et al.


Figure 4.

Blood flow through bodies of hands before and during indirect heating. Circulation to digits was arrested by rubber bands applied around the base of each digit. ○, Control hand; •, experimental hand. Atropine sulfate (0.3 mg) was infused into the brachial artery on the experimental side immediately before observations commenced.

From Roddie et al.


Figure 5.

Schematic representation of changes in blood flow in normal and nerve‐blocked hand and forearm during body cooling and heating. At CNB, vasomotor nerves to the hand and forearm skin were blocked with local anesthetic solution.



Figure 6.

Effects of body cooling and heating on blood flow in normal and cutaneous‐nerve‐blocked forearm, upper arm, calf, and thigh: ▪, right side; □, left side. CNB, cutaneous nerves on left side blocked with local anesthetic.

From Blair, Glover, and Roddie


Figure 7.

Effect of cutaneous nerve block, body cooling, and body heating on skin temperature of ear. CNB, great auricular nerve to left ear blocked; ○, left ear; •, right ear.

From Blair, Glover, and Roddie


Figure 8.

Effect of heat flow from regions of upper chest by blocking cutaneous nerve supply. Failure to dilate during body heating and absence of vasoconstrictor reflexes in nerve‐blocked areas are clearly shown.

From Fox et al.


Figure 9.

Top: record from above downward shows signal, central venous pressure, and brachial arterial pressure. Depression of signal indicates period during which both common carotid arteries were compressed. Bottom: plethysmography tracings of calf and hand blood flow before, during, and after compression of both common carotid arteries; arrows mark beginning and end of compression. Static calibrations on plethysmographic record represent 10‐ml volume increases.

From Roddie and Shepherd


Figure 10.

Effect of Valsalva's maneuver on sympathetic activity recorded in a median nerve fascicle innervating glabrous skin. Upper tracing: respiratory movements, inspiration upward. Middle tracing: integrated sympathetic nerve activity. Lower tracing: arterial blood pressure.

From Delius et al.


Figure 11.

Effects of 2 consecutive periods of neck suction on total, muscle, and skin vascular resistance and blood flow and on mean arterial pressure and heart rate in a single subject. Each point represents mean value for all determinations made during each control and intervention period.

From Beiser et al.


Figure 12.

Effect of leg exercise on blood flow in the hand (▿) and forearm (•). Left panel: average result of 19 runs on 3 subjects when increase in oxygen consumption above resting level was <500 ml/min (avg 326 ml/min). Right panel: average result of 17 runs on the same subject when increase in oxygen consumption was >500 ml/min (avg 780 ml/min). Rectangle indicates 5‐min period of leg exercise.

From Blair, Glover, and Roddie , by permission of the American Heart Association Inc


Figure 13.

Effect of severe emotional stress on arterial pressure: Δ, heart rate; •, forearm blood flow; ○, hand blood flow. During the time indicated by rectangle, the subject was led to believe that he was suffering from severe blood loss.

From Blair, Roddie, et al.


Figure 14.

Effect of 2 min of ischemia on blood flow and oxygen saturation in deep superficial veins in forearm. Hatched lines: time of ischemia.

From Dornhorst


Figure 15.

Critical closure of digital blood vessels during reduction of transmural pressure in 4 subjects. Heat flow is expressed as percentage of flow from corresponding finger of opposite hand kept under control conditions at heart level. ○, Transmural pressure reduced by hand elevation; •, transmural pressure reduced by positive tissue pressure.

From Roddie and Shepherd


Figure 16.

Effect of increased transmural pressure on oxygen saturation of blood samples obtained from deep forearm vein. Forearm was exposed to a pressure 50 mmHg below atmospheric for period shown.

From Roddie and Shepherd


Figure 17.

Approximate levels of blood flow in the hand when immersed in water at temperatures between 0°–45°C and when vasoconstrictor fiber activity is inhibited (heat load), moderate (comfortable), and intense (cold stress).

From Folkow and Neil


Figure 18.

Heat loss (in cal · 100 ml−1 · min−1) from right index finger of single subject to water at 0°–6°C. Clear area represents heat derived from circulating blood. Pain is indicated by a roughly quantitative scale at top of the figure and relationship between pain and heat loss is striking.

From Greenfield et al.


Figure 19.

Effect of histamine (10 μg/min for 3 min) on forearm blood flow. Each point is mean of 3 blood flow rates recorded in each minute during 1–2 infusions in each of 5 subjects. Vertical bars, SEM. A: •, control response (2 infusions in each subject); ○, in presence of mepyramine (avg response to 2 infusions, the 1st after 25 mg, the 2nd after an additional 3–5 mg of mepyramine); ▪, in presence of both drugs together (30–35 mg mepyramine and 10–15 mg metiamide). B: •, control response (2 infusions in each subject); ▵, in presence of metiamide (avg of response to 2 infusions, the 1st after 10 mg, the 2nd after an additional 15 mg of metiamide; ▪, in presence of both drugs together (30–40 mg metiamide and 25 mg mepyramine).

From Chipman and Glover


Figure 20.

Effect of infiltrating local anesthetic solution around radial, ulnar, and median nerves to forearm on blood flow changes with CO2 inhalation. Black rectangle indicates period when the subject breathed 12.5% CO2 in O2. ○, Nerve‐blocked forearm; •, normal forearm.

From Blair, Roddie, et al.


Figure 21.

Effect of voluntary hyperventilation with air and 5% CO2 in 95% oxygen on blood flow through hand and forearm. •, Intact hand or forearm; ○, nerve‐blocked hand or forearm. Periods between dotted lines represent periods of hyperventilation.

From Roddie et al.
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Ian C. Roddie. Circulation to Skin and Adipose Tissue. Compr Physiol 2011, Supplement 8: Handbook of Physiology, The Cardiovascular System, Peripheral Circulation and Organ Blood Flow: 285-317. First published in print 1983. doi: 10.1002/cphy.cp020310